Game Elements and Instruments for Assessing Nursing Students' Experiences in Learning Clinical Reasoning by Using Simulation Games: An Integrative Review

Background: The use of game elements motivates students to learn and positively affects students' learning outcomes. The purpose of this review is twofold: to analyze (a) game elements in simulation games and (b) the instruments used to assess nursing students' experiences in learning clinical reasoning (CR) by using simulation games. Method: The review includes nine studies retrieved from eight electronic databases. The data were analyzed deductively and inductively. Results: The analysis revealed that the use of several game elements in simulation games was rare. Moreover, although several self-developed instruments used to assess students' experiences in learning CR were found, most of the instruments were poorly validated. Conclusions: More game elements should be implemented in simulation games used by nursing students to learn CR. Moreover, the instruments used to assess nursing students' experiences in learning CR through simulation games should be further developed and validated.